December 28, 2021

Well, this is kind of a dorky workaround, but I found in the “Additional CSS” settings where I can instruct the CSS to show [ em ] as italicized. You know. Which it… should just naturally do when I’m formatting in WordPress. Ugh. Technology!

ANYWAY. Back to our story.

Every day I kind of thought “whew, it can’t get any worse than yesterday, right?” and then HAHAHAHA.

I won’t say I love you, babe,
I won’t say I need you, babe,
But I’m gonna get you babe
And I will not do you wrong.

Living’s mostly wasting time
And I’ll waste my share of mine
But it never feels to good,
So let’s don’t take to long.

You’re soft as glass
And I’m a gentle man
We got the sky to talk about
And the earth to lie upon.

GUESS WHO’S WON ANOTHER NIGHT AT CLUB SHANDS????

So the first thing that happened this morning was his nurse saw me in the hallway and walked down to his room with me – everything is fine but boy howdy did that put my heart in my throat! She was just headed this way to put a sign on his door that says no food/no water after midnight tonight (IS HE A GREMLIN???) – so looks like we’re staying at least one more night. He’s getting another TEE (transesophageal echocardiogram) tomorrow. That’s the one he had at North Florida last week, and they still haven’t been able to get the records from North Florida, so they’re going ahead and doing another. Basicially they stick a camera down your throat and get a better look at the back of the heart, to see if that’s where the clots are forming.

Yesterday one of the nurses told me that his white blood cell count was a little high, and today Terri told me that they found some “Gram positive cocci” in his blood, which confirms he does have some sort of infection (I’ll know more when the doctors come in sometime this morning… maybe even as I’m typing this up?). It could be Strep, it could be a Staph infection, could be Pneumonia, could be food poisoning… I just don’t know yet. They have checked his incision site from the surgery on Friday and everything is clean and healing; no swelling, no redness, no lump or hematomae, so it’s almost certainly not from that. I 100% do not want any of y’all to worry about this, he actually looks a thousand percent better today than he did yesterday (maybe it’s that he got to shave? A furry Timmy is a weird Timmy). He was up and talking when I got here a little while ago, I think he talked more in five minutes than he has the last two days — but the second the nurse left and I sat down, he was out like a light. Well, “working on his puzzle”… by that I mean “napping while the puzzle is on a tray in front of him.”

This. This right here… “today Terri told me that they found some “Gram positive cocci” in his blood“… that was it. That was the Endocarditis finally starting to show up in the original four vials of blood that I had not noticed them taking on the first day. This was day four, I believe they took the first samples on Day One, after he got up from the ER but before I was in to see him. It takes four days for the cultures to grow. They took another set of samples on the day before this, because they suspected what they thought was starting to grow, and they wanted to get Round Two started, for a control/verification. It’s important to know this means, when I say “it takes four days to grow” that I’m talking about the cultures in the lab — not what was already in his bloodstream, already in his heart. That? That was already growing. Grown, even.

They’re also really pleased with the heparin, even though they still haven’t managed to hit just the right dose. They raise it, check him in six hours, lower it, check him in six hours, raise it again… it’s like me trying to adjust the volume of the TV!

I think the doctors usually make rounds between 10:30-11:30 so I’ll let you know when I know more. Please don’t worry! He looks really good, for a cranky dude who’s been in the hospital and wants to go home and was just told he’s staying another day!

Let’s see… 11:30 and still no doctors; I just remembered that Nurse Terri told me she thinks they’re having a crisis somewhere else in the hosptial because our floor is on a skeleton staff today – they came by this morning before I got there and pulled a bunch of her nurses to go somewhere else in Shands. So maybe they’re just behind because of whatever that is.

As I said on Facebook when I posted the above picture…

12:00, and the doctors just came in, thew info, and left. So, let’s see. The halo ultrasound did show that he has a PFO, and also that there might be some issue with a heart valve. They said that an infected heart valve can be a cause of strokes, HOWEVER, that they also got his information from North Florida and when we brought him in there, he had a regular white blood cell count and his heart valve was normal. So anything that has happened to his heart in the last ten days happened post-the-first-stroke. Strokes don’t cause infections, but infections can cause strokes, but it looks like he didn’t have an infection before his first stroke.

In hindsight, yes; he did have the infection before his first stroke. We just didn’t know it because it was taking so long to grow.

Oh, Timmy Sean, you just gotta be difficult! They definitely want to narrow that down, hence the second TEE tomorrow (first one at North Florida last week), so they can be aware of any changes. They don’t think it’s an infection caused by any incisions or anything – his only surgical incision was here, and it’s completely clean, and none of his IV points look infected at all. So Infectious Disease is going to come by some time this afternoon after reviewing his records and charts. They are 100% certain it’s an internal infection, not, like, something I need to leave the room because of, and take some sort of hazmat shower myself. I just can’t, like, cut him open or anything. 😉 I also got the name of his doctors which… I promptly forgot because forgetting names is my superpower. I think that’s everything for right now???

Oh, visitors, in case he’s still in here when y’all get here tomorrow. He’s allowed four visitors total for his entire stay, and we’ve already used three visitors, so we have one spot left… which unfortunately means that we’ll have to flip a coin for Bill vs Linda vs Jenny. I’m sorry, I didn’t think we’d still be in here when you guys got here, and we used the third spot yesterday for his supervisor from work so she could come in and talk to us about Short Term Disability if he’s not cleared to go right back to work.

Days, up and down they come
Like rain on a conga drum
Forget most, remember some
But don’t turn none away.

Everything is not enough
And nothin’ is to much to bear.
Where you been is good and gone
All you keep is the getting there.

To live is to fly
Low and high,
So shake the dust off of your wings
And the sleep out of your eyes.

2:30
Just talked with Dr. John Peterson (look at me, writing down a name ASAP! That’ll never happen again!) and he’s the cardiologist who’ll be doing the TEE tomorrow. He said one of the things they want to look at is if perhaps Tim has what they call an ASD and not a PFO. ASD means Atrial Septal Defect, and according to Doctor Google, “PFO is a flap-like hole in the inter-atrial septum that can allow blood to go from the right to left chambers and could be a cause for stroke. ASD is a defect (hole) in the inter-atrial septum that typically allow blood to go from the left to right chambers and can lead to symptoms and reduced heart function”. I gather from Dr. Peterson that how they treat those two things are slightly different, so they want to make sure which one it is before they go in and try to close it up.

Again, hindsight… So, it turns out? PLOT TWIST, IT WAS NEITHER. The shadow they were seeing, what they THOUGHT was a hole, was the vegetative mass of the endocarditis growing on his mitral valve.

3:15
Total chaos in here for a bit when after Dr. Peterson came in, his …. minion (?) doctor came in to talk to us as well, explain everything the other guy had just explained, but louder, so that Tim would actually wake up for it (narrator voice: Tim did not wake up). About a minute before he was done, another doctor came in, the Infectious Disease doctor, with many questions ranging from what travel has he done recently to what wild animals live on our property and have any of them recently bit Tim, and/or has he maybe fallen face-first into a cat box recently… maybe Tim got thirsty and drank out of a stagnant pool of water…. basically, anything about his recent actions that could show up on an episode of House. 😉 While she was in there, both Soft-spoken Cardiologist and Loud Cardiologist came back, deliberately woke Tim up, to go over everything that they’d gone over with me that he’d slept through. I didn’t catch much of what they were saying because Infectious Disease Doctor was still playing Agatha Christie. THEN while all of that was happening, Nurse Terri came in to change his Heparin levels again, because they’re still trying to get him… what do they call it… therapeutic. They keep raising and lowering the levels, trying to get it perfect, but they have to wait six hours in between raising and lowering to see if they got it right. Uh…. then everyone kind of left at once, and now Tim has fallen asleep again, and I’m sitting here like WHAT JUST HAPPENED THAT WAS TOO MANY PEOPLE AT ONCE. Seriously, he’s only allowed four visitors his entire stay, but six different doctors and nurses can be in here at once, multiple times a day??? Oof. I need a donut.

5:00
The other Infectious Disease doctor just left, after asking a lot of the same questions from earlier, doing follow up. Her concern is that they took four bottles of blood yesterday, and the same bacteria is growing in all four. I say “concern” because she says if it was only growing in one, they’d write that off as contaminated, as they take two bottles from each arm. But the same is growing in all four, so whatever is in him, is in him (and not contaminated on the outside). Worst case, she says, he needs four weeks of IV antibiotics. Best case, they cure it with the Vancomycin they just put him on a couple hours ago. She also reiterated that some infections can cause strokes, but again, he had his first two strokes before any sign of infection. The infection, btw, is a common one that all of us have on the outside of our skin, and it’s usually gotten into the blood via a puncture, scrape, or open wound.

Goodbye to all my friends
It’s time to go again
Think of all the poetry
And the pickin’ down the line.

I’ll miss the system here
The bottom’s low
And the treble’s clear
But it don’t pay to think to much
On things you leave behind.

I will be gone
But it won’t be long
I will be a’bringin’ back the melodies
And rhythm that I find.

Oof, y’all, I am weary. OK, here was the rest of the day —

people in
more people in
still more people in
first guy out
another person in
some people out
another person in
some person out
is everyone out now
please go away
everyone please just leave
omg stop coming in
is there a number of people the fire department says is too high for this room
srsly what

I don’t blame Tim for ignoring all of these people … like, seriously, about the fourth time a group of people came in, he either actually kept sleeping, or was doing a really good job of pretending to sleep through it all. Either way, he let me talk to everyone, and take care of everything (except when the people who had been there before straight up woke him up this time to get his version of the answers I already gave them, which were exactly the same but in less syllables).

The long and short of it is that they put him on a heavy duty antibiotic because he’s either working on getting an infection, or he had a small infection somewhere, inside, that started this whole thing. Infections of this sort can cause strokes, but strokes don’t cause this infection. So he’s definitely there through tomorrow, and he may be there through the 30th, because of the antibiotic drip.

He’s getting another TEE (transesophageal echocardiogram) tomorrow (he had one of those at North Florida last week); one of the things they want to look at is if perhaps Tim has what they call an ASD (Atrial Septal Defect) and not a PFO (Patent Foramen Ovale). Because apparently you repair them differently or something? I don’t care, just fix him. Figure out where the strokes are coming from and fix him, please and thank you.

And don’t tell him, but I stopped at Satchel’s on the way home today and got a big salad with ham and feta to bring in for us to munch on tomorrow. Shhh, keep it a surprise!

Oh, and it looks like I did post this day on Facebook, because I found this in the comments:

We all got holes to fill
Them holes are all that’s real.
Some fall on you like a storm,
Sometimes you dig your own.
The choice is yours to make,
Time is yours to take
Some sail upon the sea,
Some toil upon the stone.

To live is to fly
Low and high,
So shake the dust off of your wings
And the sleep out of your eyes
Shake the dust off of your wings
And the tears out of your eyes

Lyrics by Townes Van Zandt
To Live is to Fly

Whew. What a day. And tomorrow was going to be … even better. “Better.” You keep using that word, I don’t think that word means what you think it means.

xoxo y’all